Pyelectasis in the fetus. Renal pyelectasis in the fetus: treatment and causes

According to statistics, pyelectasis in the fetus is not very common — approximately 2% of cases during ultrasound examination of the fetus, the doctors observed a similar pathology. Naturally, expectant mothers ask questions about what constitutes disease, how dangerous is it and what treatment methods offers modern medicine.

Renal Pyelectasis in the fetus - what is it?

What is this disease? Unfortunately, this pathology of the fetus in contemporary obstetric and paediatric practice, there are, albeit not very often. Pyelectasis — a condition that is accompanied by excessive expansion of the renal pelvis, which is often associated with obstruction of normal urine outflow.

In most cases the disease develop during the fetal development using ultrasound examination. Often diagnosed pyelectasis on the left in the fetus, as well as the defeat of the right kidney or bilateral extension of pelvis. According to statistical studies, boys suffer from this disorder in the 2–3 times more often than girls. In fact, the disease if untreated can lead to dangerous complications.

Main causes of disease

Modern medicine there are many causes that can lead to pathological widening of the pelvis and the violation of the outflow of urine. First and foremost it should be noted that there is a genetic predisposition. In addition, fetal pathology may develop in the event that if during pregnancy the mother suffered from the pyeloectasia. On the other hand, the risk factors include acute inflammatory diseases of the urinary system, transferred by the female during gestation. Moreover, the probability of violation of normal development of the kidney in a child increases in severe pregnancy, such as having pre-eclampsia, eclampsia, etc.

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In some cases, to the pyeloectasia lead various anomalies of development. For example, some children formed the valve in the transition region between the pelvis and the ureter. Sometimes the ureter can be squashed by large blood vessels or other adjacent organs. Risk factors also include irregular growth and formation of organs during fetal development. Some children extension of pelvis is the result of weakness of the muscular system that often occurs in prematurity.

How to determine the presence of the disease?

Most Often, renal pyelectasis in the fetus is diagnosed in the second half of pregnancy (during a routine ultrasound). Of course, to make an accurate diagnosis based on one test only is impossible, because the child's body is constantly growing, evolving and changing. However, it is considered that up to the 32nd week of pregnancy the size of the renal pelvis is 4mm, and then — to 7–8 mm. If, during an ultrasound examination it is established that the size of the pelvis exceeds 10 mm, it is appropriate to speak about the presence of the disease.

In the future additional tests that help to identify the cause of the pathology development. The main physical signs of pyeloectasia appear after birth. In any case, a sick baby prescribed research such as intravenous urography, cystography, isotopic examination of the kidneys, etc.

Diseases that are accompanied by pyelectasis

Most Often pyelectasis in the fetus indicates the presence of certain diseases, which include:

• Hydronephrosis-a disease caused by the presence of obstruction at the transition between the pelvis and the ureter. The pelvis expand, but the condition of the ureter corresponds to the norm.
• Megaureter — another disease that occurs with pyelectasis. Thus the patients have vesicoureteral reflux. The ureter narrows in the lower part, and in the bladder there is a sharp increase in pressure.
• Vesicoureteral reflux is accompanied by backward reflux of urine into the kidney, thus there is a significant expansion of the renal pelvis.
• Ectopia — another condition in which the ureter empties not into the bladder and the vagina (in girls) or urethra (boys). Most often this pathology is observed when doubling the kidney.
• Pyelectasis in the fetus can be paired with ureterocele. When this pathology of the ureter at the point where the bubble greatly inflated, but the outlet is very narrow.

Major complications of the disease

Of Course, this pathology of the fetus do not occur very often. Many people wonder about how dangerous it can be pathological. In fact, the threat in this case is not an extension of the renal pelvis, and the causes that lead to disease.

If the normal flow of urine from the kidney is hampered, it affects the work of the urinary system. In particular, when such pathology is observed the compression of the tissues of the kidneys. In the absence of treatment structure of the body slowly atrophy. The decreased kidney function dangerous for the entire body and often ends in completeloss of renal structure, which, of course, dangerous. In addition, against the background of stagnation of urine can develop various inflammatory diseases, including pyelonephritis. In any case with suspected pyelectasis is a complete examination to discover the cause of such violations.

How to treat a pyelectasis?

In fact, doctors can not determine whether the disease to progress after birth. For example, two-sided pyelectasis in the fetus is considered a physiological condition, which is caused by excessive amount of fluid in the body of the mother and child.

That is why in the first weeks or months of life a child undergoes regular examinations to ensure that doctors can detect if the disease progresses. Quite often, mild, moderate pyelectasis goes away by itself with age. If conditions have not improved, your doctor may prescribe conservative treatment.

The Treatment in this case depends on the cause of the pathology development. For example, if the extension of the pelvis occurred on the background of urolithiasis, the patient is administered special drugs that promote dissolution of solid formations and rapid removal of sand from the urinary system.

In some cases, surgical intervention is necessary?

Unfortunately, to eliminate the disease by conservative methods can not always. Question about surgical intervention solves the attending physician in the monitoring process. For example, if a baby has discovered a progressive pyelectasis, which is accompanied by the rapid expansion of the pelvis and a gradual loss of kidney functions, you need surgery. According to statistics, approximately 25–40% of cases surgery is performed in childhood.

Today, there are many methods of treatment of such diseases. Often during the procedure, the physician removes the obstacle, hindering the normal flow of urine. In most cases, surgery is performed using endoscopic devices that are introduced through the urethra. Abdominal procedure is required only in very serious cases.

Forecasts for a child

Unfortunately, to prevent such disease is almost impossible. The only thing that should be recommended to pregnant women, especially if their history of a similar disease, — to monitor closely the state of health, to observe the water balance, and also treat all kidney disease.

As for the forecast for the newborn, most often after a properly conducted surgical operation, the disease goes away. However, there is no guarantee that pyelectasis kidney will not return in childhood or adulthood. That is why such children should undergo regular examination by a specialist — only this will allow to detect pathology in its initial stages.